u/Ill-Performance-816

I’m 43 and have been taking omeprazole for more than 15 years. When I was younger I had episodes of acute esophagitis and was taking 20 mg or more. Over the years this was reduced to 10 mg/day, but I’ve found it very difficult to stop completely: when I try, reflux/gastric discomfort tends to return and I eventually restart it.
My diet is pretty normal — regular meals, no particular restrictions or major food excesses, occasional alcohol.
I recently had a new gastroscopy. It showed a small uncomplicated cardio-tuberositary malposition (mild anatomical predisposition to reflux) and non-ulcerative gastritis, but importantly no current esophagitis or visible reflux damage. H. pylori was negative. They also found benign fundic gland polyps, considered likely related to long-term PPI use.
My gastroenterologist now recommends lifestyle measures and omeprazole on demand rather than continuously.
I’m curious about people with a similar history: 10–20+ years of daily PPIs, particularly after previous esophagitis. Did you manage to stop or switch to on-demand use? Did you taper? How bad and how long was the rebound acid hypersecretion?
My biggest question is how to distinguish temporary rebound after 15+ years of omeprazole from the underlying reflux actually returning.

I’m 43 and have been taking omeprazole for more than 15 years. When I was younger I had episodes of acute esophagitis and was taking 20 mg or more. Over the years this was reduced to 10 mg/day, but I’ve found it very difficult to stop completely: when I try, reflux/gastric discomfort tends to return and I eventually restart it.
My diet is pretty normal (regular meals, no particular restrictions or major food excesses, occasional alcohol).
I recently had a new gastroscopy. It showed a small uncomplicated cardio-tuberositary malposition (mild anatomical predisposition to reflux) and non-ulcerative gastritis, but importantly no current esophagitis or visible reflux damage. H. pylori was negative. They also found benign fundic gland polyps, considered likely related to long-term PPI use.
My gastroenterologist now recommends lifestyle measures and omeprazole on demand rather than continuously.
I’m curious about people with a similar history: 10–20+ years of daily PPIs, particularly after previous esophagitis. Did you manage to stop or switch to on-demand use? Did you taper? How bad and how long was the rebound acid hypersecretion?
My biggest question is what drugs you have found as an effective replacement and how to distinguish temporary rebound after 15+ years of omeprazole from the underlying reflux actually returning.